| NPI | 1730606690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT32816) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL PT32816) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-07-21 |